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Molluscum

Maladywise

SUMMARY: Molluscum contagiosum virus infections and current treatment guidelines.

Fact Sheet

Introduction

Common chronic, localized infection, consisting of skin-coloured, dome-shaped bumps on the skin, usually in children.

Virology

Poxvirus

Epidemiology

Four distinct gentoypes

MCV1 most common > 90% of cases

25% of people have positive serology

Risk Factors

Common in childhood

In adults can be linked to sex and contact sports

Associated with immunodeficient states

Transmission

Skin to skin contact

Indirect contact via shared towels or items

Auto-innoculation from shaving or scratching

Sexual transmission in adults

Molluscum prefers wet conditions such as swimming or bathing together

Incubation periods about 2 weeks but can be 6 months

Clinical

Clusters of small, round papules

1 to 6 mm in diameter, but can grow to 2cm

May be white, ink or brown

Waxy shiny look with small central pit

Papules contain white cheesy material

Mostly arise in warm moist places, armpit, behind knee, and groin

Complications

Secondary bacterial infection from scratching

Conjunctivitis if eyelid infected

Disseminated eczema

Scarring

Diagnosis

Clinical

Treatment

As molluscum is self-limiting, treatment is not always necessary.

Physical

  • Taping

  • Picking out the soft white core

  • Cryotherapy

  • Curettage

  • Laser ablation

Medical

  • Antiseptics such as hydrogen peroxide cream or iodine

  • Podophyllotoxin cream

  • Wart parts containing salicylic acid

  • Cantharidine solution

Outcome

In people with a competent immune system, molluscum is harmless. They may persist for up to 2 years. 50% of cases in kids clear by 12 months and 67% by 18 months.

Prevention

Keep hands clean

Avoid scratching or shaving

Cover all visible lesions with clothing or water-tight bandages

Dispose of used bandages

Do not share towels, clothing or their personal effects

Adults should practice safe sex or abstain

Treat any associated eczema

Reference

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